1. Proportion of reimbursement for outpatient expenses of on-the-job personnel: less than or equal to 3,000 yuan: 80% for free medical care; Personal burden 20%; More than 3,000 yuan: 90% of medical expenses are reimbursed, and the personal burden is 10%.
2. The reimbursement rate of hospitalization expenses: 1 0,000 yuan or less: 90% for medical reimbursement at public expense and10% for personal burden; 1 ,000 yuan or more: 94% of medical expenses are reimbursed and 6% is borne by individuals.
The process of medical insurance reimbursement:
1, medical treatment: go to a hospital or clinic for medical treatment or treatment;
2. Payment: Pay the medical expenses that should be paid in the hospital or clinic;
3. Obtain a list of expenses: during the medical treatment, the hospital or clinic will provide a list of expenses, which lists the specific medical items and amount;
4. Fill in the reimbursement application form: hold the expense list and fill in the medical insurance reimbursement application form. You need to provide your own basic information, medical expenses list, medical insurance certificate and other related materials when filling in;
5. Submit materials: submit the completed reimbursement application form and related materials to the medical insurance agency, which can be submitted online or offline;
6. Audit: The medical insurance agency shall audit the submitted application forms and materials. After the approval, the medical insurance agency will transfer the reimbursement to the personal bank account or give cash reimbursement.
To sum up, different regions and different medical insurance systems may have different participation conditions, payment standards and reimbursement scope. When participating in medical insurance, residents need to understand local laws and policies and consult the staff of local social insurance agencies.
Legal basis:
Article 28 of People's Republic of China (PRC) Social Insurance Law
Medical expenses that meet the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency rescue shall be paid by the basic medical insurance fund in accordance with state regulations.
Article 29
The medical expenses of the insured shall be paid by the basic medical insurance fund, and shall be directly settled by social insurance agencies, medical institutions and pharmaceutical business units.